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ATOD & Advocacy Update - Week Ending August 9, 2013

Alcohol a Top Factor in Many Fatal Crashes Involving Recreational Boats
Alcohol plays a major role in almost 20 percent of deadly crashes that involve recreational boats, according to The Journal News. The U.S. Coast Guard announced earlier this year that 109 of the 651 people—17 percent—who died in boat crashes nationwide last year were killed in accidents in which alcohol was the leading contributing factor. Boat operators are considered legally intoxicated if they have a blood-alcohol content level of 0.08 percent or more. The Coast Guard website notes alcohol has many physical effects that threaten safety and well-being on the water. Drinking impairs boaters in many ways, including affecting cognitive abilities and judgment, physical performance and vision. “As a result of these factors, a boat operator with a blood alcohol concentration above .10 percent is estimated to be more than 10 times as likely to die in a boating accident than an operator with zero blood alcohol concentration. Passengers are also at greatly increased risk for injury and death—especially if they are also using alcohol,” the Coast Guard states.

Tobacco Companies Follow Old Tactics in Marketing E-Cigarettes
Tobacco companies are using marketing tactics for their e-cigarettes that are similar to the ones they have used for regular cigarettes, including sponsoring race cars, using cab-top and bus stop displays, and buying TV ad time to tell smokers to take back their freedom, the Associated Press reports. “Right now it’s the wild, wild west,” Mitch Zeller, Director of the Food and Drug Administration’s (FDA) Center for Tobacco Products, told the AP. The second-largest tobacco company in the United States, R.J. Reynolds, is launching an e-cigarette called Vuse. The company plans print, TV and direct mail marketing. Altria, which owns Philip Morris USA, the country’s largest tobacco company, has its own e-cigarette brand. The nation’s third-largest tobacco firm, Lorillard, will spend $40 million on marketing its e-cigarette, Blu. E-cigarettes are not regulated by the FDA, so tobacco companies can market them through television ads. Traditional cigarette television ads have been banned since 1971. Tobacco companies have cut back on magazine ads since the Master Settlement Agreement of 1998 established broad restrictions on cigarette marketing. Some convenience stores and gas stations display e-cigarettes at the front counter, which is off-limits for regular cigarettes, the article notes. The tobacco industry is awaiting the FDA’s decision on how it will regulate e-cigarettes. Some experts say any regulations would likely result in a court battle, which would delay the regulations from going into effect. Public health groups are concerned the companies’ marketing tactics will lure young people to start using e-cigarettes. It is unclear how safe they are, the groups note. Sales of e-cigarettes could reach $2 billion by the end of 2013, according to analysts. E-cigarette use could surpass that of regular cigarettes in the next decade, some analysts predict.

France Finally Finds the Right Words to Describe Binge Drinking
The French Ministry of Culture and Communication, better known as the language police, added a decidedly un-French term to its approved lexicon on Sunday. From now on, chugging alcohol with the sole motive of getting smashed is no longer “le binge drinking” — it’s la beuverie express (literally, fast drinking). French authorities are well-known for combating the encroachment of English into the Language of Love, most recently by creating a domestic equivalent for hashtag: mot-dièse. The authorities’ determination to keep their language free from the vulgarities of English, however, reveals a growing problem in France. After all, if binge drinking weren’t on the rise, the government would have little reason to create its own dictionary entry for the phenomenon.
Binge drinking has gone largely undocumented in the country, with the assumption that such crass methods of imbibing were solely for those in less-civilized nations. Au contraire. Last month, the National Institute for Prevention and Health Education found that 25.5 percent of those surveyed between the ages of 15 and 30 admitted to having six or more drinks on one occasion over the past month, according to the International Business Times. That many drinks at a time seems to fit the official French definition of la beuverie express, “the massive absorption of alcohol, generally in a group, aimed at provoking drunkenness in the minimum amount of time.” Binge drinking is an unusual foreign term to be given a domestic word in France, since the commission has largely devoted its efforts to appropriating technology terms like cloud computing. No word from the French authorities if it’s less problematic to engage in la beuverie express than binge drinking.

Frequent users of marijuana, alcohol already know health risks, study shows
Users of marijuana and alcohol may be savvier about the health risks posed by these substances than those who abstain, new research suggests. The findings, which were drawn from a large sample of Swiss men, showed that men who frequently used marijuana, alcohol and tobacco sought out information about the health risks of those substances more than those who didn't use them. Please click here to read more.

Commentary: Countering the Myths About Methadone
Methadone maintenance has been used in the United States for approximately 50 years as an effective treatment for opioid addiction. Yet many myths about its use persist, discouraging patients from using methadone, and leading family members to pressure patients using the treatment to stop. Please click here to read more.

More Than One-Third of Pedestrians Killed in 2011 Were Drunk: Government Report
A new government report shows 37 percent of U.S. pedestrians killed in 2011 were drunk, USA Today reports. Thirty-five percent of those killed—1,547 people—had blood alcohol levels that were at or above the legal limit for driving. The report, by the National Highway Traffic Safety Administration (NHTSA), found among the 625 pedestrians ages 25 to 34 who were killed, half were impaired by alcohol. Jonathan Adkins, a spokesman for the Governors Highway Safety Association, told the newspaper campaigns to reduce drunk driving may be having an unintended effect, by encouraging more drunk people to walk home. A person impaired by alcohol can make bad decisions, such as crossing against the light, or “trying to beat a bus that’s coming,” he said. The NHTSA announced it is making $2 million in pedestrian safety grants available to cities with the highest rate of pedestrian deaths. It is launching a website, with the Federal Highway Administration, that provides safety tips and resources for improving pedestrian safety.

Experts Say Many People Addicted to Opioids Not Getting Adequate Treatment
Many people addicted to opioids are undergoing short-term detoxification, instead of receiving long-term maintenance treatment, according to a new report. In the journal Health Affairs, eight experts write this means many people are not receiving adequate opioid addiction treatment. Dr. Bohdan Nosyk and seven other experts note that excessive regulation in the United States prevents many people addicted to opioids from receiving long-term maintenance treatment with methadone. Instead, many people undergo short-term detox, which lasts from three to 12 weeks, and is focused on achieving abstinence from opioids. He told PBS NewsHour, “We’ve known for decades that detox is ineffective in getting, and keeping people off of opioids. This is true even in youths who don’t inject and had relatively little experience with opioids before entering treatment.” He said the treatment is extremely dangerous, because people addicted to opioids are at highest risk of death in the first two weeks of treatment and in the two weeks after treatment ends. “That means a three-week detox regimen exposes addicts to an extremely high risk of death for four out of five consecutive weeks. So, aside from being ineffective, it’s extremely dangerous.” In the United States, methadone is only available in specialized treatment centers, not in regular doctors’ offices, Dr. Nosyk explained. He said another opioid addiction treatment, buprenorphine, can be prescribed in physicians’ offices. “Methadone is a more effective, and considerably cheaper medication, and may therefore provide better value for money while further expanding access to treatment,” he said. He called for eliminating restrictions on office-based methadone prescribing in the United States. In Health Affairs, Dr. Nosyk wrote that fewer than 10 percent of all people dependent on opioids in the United States are receiving treatment with methadone or buprenorphine. The proportion may increase as more people receive health insurance through the Affordable Care Act, he said.

Reuniting with a Loved One in Recovery: Five Key Questions
When it comes to family members in recovery, this dilemma is oh-so-typical. It’s complicated to say the least and multiple issues come into play. Click here to read more.

5 Steps to Stop Drug Addiction Before it Starts
Recovering from addiction can be a difficult and taxing process. Certain people are much more susceptible to addiction, as factors such as genetics or environmental issues can make substance abuse much more likely. There are, however, several effective ways to prevent drug addiction.Find out more here.

Performance-Enhancing Drugs: A Cheat Sheet
Since steroids hit the U.S. sports scene more than 50 years ago, athletes have found new ways to get faster and stronger -- and to avoid getting caught. Rest of this article is here.

ScienceShot: A Shot of Coffee That Gets You Drunk
 Now you can get a new kind of buzz from coffee. Researchers have found a way to turn used coffee grounds into an alcoholic beverage. In recent years, the industry of distilled spirits has put out a call for new beverages with different flavors created from unusual raw materials. To answer this call, some scientists examined the potential of used coffee grounds. The scientists first collected this raw material from a Portuguese coffee roasting company and dried it. Then they heated the powder in water at 163°C for 45 minutes, separated out the liquid, and added sugar. Next, the team mixed in yeast cells, let the concoction ferment, and concentrated the sample to get a higher alcohol content. (A similar process is used to produce other distilled beverages such as whiskey and rum from wheat and molasses.) And voilà! Used coffee grounds produced a new alcoholic beverage with 40% ethanol, comparable to other hard liquor such as vodka and tequila, researchers will report in the September issue of LWT - Food Science and Technology. To evaluate the product, eight trained taste testers were brought in and rated the intensity of different smells and flavors in the alcohol. The judges described the drink as smelling like coffee and tasting bitter and pungent. Researchers noted that the taste could be improved with age and concluded that the quality was good enough for consumption. Don’t count on the caffeine to keep you awake, however; most of it disappears in the brewing process.

DUI ruling gives defendants tool to rebut breath results
PHOENIX - The state's high court has given those charged with drunken driving a new tool to try to defeat charges against them. In a unanimous ruling Monday, the Arizona Supreme Court said defendants can present evidence to jurors that there are variables among individuals, including body temperature, that make it impossible to precisely convert a breath reading to someone's specific blood-alcohol content. That can be crucial in determining whether a person is legally impaired.  Continue reading here.

Gene combinations help predict treatment success for alcoholism medication
An experimental treatment for alcohol dependence works better in individuals who possess specific combinations of genes that regulate the function and binding of serotonin, a brain chemical affected by the treatment, according to a study supported by the National Institutes of Health. A report of the finding appears online in the American Journal of Psychiatry."This study is another important step toward personalized treatments for alcohol dependence," says Kenneth R. Warren, Ph.D., acting director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which funded the study. "A personalized approach based on a person's genetic makeup is increasingly being investigated for delivering optimum treatment to the 'right' patient." Ondansetron is a medication currently used to treat nausea and vomiting, often following chemotherapy. It works by blocking serotonin-3 receptors, and has shown potential as a treatment for defined subpopulations with alcohol dependence. In previous studies, Professor Bankole Johnson, D.Sc., M.D., and his team at the University of Virginia, Charlottesville, have shown that variations in genes that encode the serotonin transporter, a protein that regulates the concentration of serotonin between nerve cells, can significantly influence drinking intensity. They have also shown that the effectiveness of ondansetron therapy among people with alcohol dependence is influenced by variations of the serotonin transporter gene. In the current study, Professor Johnson and his colleagues extended their prior work by analyzing variants of serotonin receptor genes, collectively designated as HTR3, among nearly 300 alcohol-dependent individuals who were participating in a clinical trial of ondansetron. They found that three HTR3 variants were significantly associated with the effectiveness of ondansetron treatment for alcohol dependence. "Taken together, these studies implicate a collective effect of serotonin receptor and transporter gene combinations, defined by a five-marker genotype panel, on the response to treatment with ondansetron for a genetically defined subpopulation of individuals with alcohol dependence," says Professor Johnson. "Multi-site, larger studies are about to begin to progress this work." Explore further: Anti-smoking medication shows promise for treating alcohol dependence  More information: Johnson, B. et al. Determination of genotype combinations that can predict the outcome of the treatment of alcohol dependence using the 5-HT3 antagonist ondansetron, American Journal of Psychiatry. 2013 July 30 Journal reference: American Journal of Psychiatry.

Alcohol Use, PTSD Improve with Naltrexone
The frequency of alcohol consumption decreased significantly more with naltrexone than with placebo in patients with comorbid alcohol dependence and post-traumatic stress disorder (PTSD), a randomized trial showed. The addition of opioid receptor antagonist to exposure therapy or supportive counseling resulted in the largest decreases in drinking days (about 65% to 70%), reported Edna B. Foa, PhD, of the University of Pennsylvania in Philadelphia, and colleagues. Continue reading here.

Performance-Enhancing Drugs Can Have Severe Long-Term Impact on Health: Expert
Performance-enhancing drugs (PEDs), which led to the suspension of 13 Major League Baseball players this week, can have severe long-term health effects, an expert tells Fox News. In the short term, hormones or steroids can strengthen muscles, bones and tendons. Dr. Robert Truax, who practices family and sports medicine at University Hospitals Case Medical Center in Cleveland, says the drugs allow athletes to train harder and longer, with fewer injuries. PEDs come in various forms, including pills, injections or creams. Athletes often use the drugs for short periods, then stop days or weeks before they get tested, to allow the drugs to leave their system. “You can cycle it so you have moments of medicine in you, do aggressive training and the medicine helps enhance that training,” Truax said. “Then they get off of it, and hopefully their training without the medicine is a little bit better.” In the long term, PEDs can cause impotence, worsening acne, balding and “steroid rage.” PEDs can also stunt growth in adolescents, the article notes. More serious effects include heart and liver damage, and an increased risk of blood clots. “The heart is a muscle…and the heart isn’t designed to have that much testosterone stimulating it,” Truax said. “So it will grow abnormally. Then, the testosterone gets broken down by the liver so too much of it can accumulate in the liver and damage it.” In January, MLB and its players union announced they reached an agreement to conduct in-season blood testing of players for human growth hormone. Players also will be tested for synthetic testosterone, which is increasingly popular because it washes out of the body fairly quickly after being used.

Heroin Use Soars in Rural Areas
Rural areas are seeing a surge in heroin use, The Wall Street Journal reports. The rise comes as Mexican heroin production has increased in recent years. Officials seized 1,989 kilograms of heroin at the Southwest border, from Texas to California, in 2012, up from 487 kilograms in 2008, the article notes. Many people who were addicted to prescription painkillers switched to heroin after drug companies made their products more difficult to crush and snort. Heroin is also much less expensive than pills such as oxycodone. According to the 2011 National Survey on Drug Use and Health, the number of people who were past-year heroin users in 2011 (620,000) was higher than the number in 2007 (373,000). “Basically, you have a generation of ready-made heroin addicts,” Matthew Barnes, special agent in charge of the Drug Enforcement Administration’s Seattle division, told the newspaper. According to drug experts, heroin is generally purer and more potent today than in decades past. This increases the risk of an overdose. Rural areas experiencing an increase in heroin use often are unprepared to respond. They do not have adequate treatment facilities, or hospital emergency rooms that can treat overdoses. Local police forces do not have the staff to handle an increased level of narcotic investigations and drug-related crimes. Skip Holbrook, the Police Chief in Huntington, West Virginia, where heroin has become the biggest drug problem, says the drug “transcends all areas of our town. It is absolutely the most pressing issue that we face.”

“G-Pen” Vaporizer Used for Medical Marijuana Becoming Popular With Teens
A device used for medical marijuana, called the “G-Pen,” is becoming popular with teens, MyFoxNY reports. The G-Pen sells for $90 in New York’s East Village, and is also sold online. Less expensive models are also available. One G-Pen model is called The Game/G-Box, named after the popular rapper The Game, who has a reality show on VH-1. He’s in his 30s, but appeals to a younger audience, the article notes. The G-Pen looks like a pen or electronic cigarette. It doesn’t produce smoke or an odor, which makes it appealing to teens who want to use marijuana without attracting attention.

Don't treat heroin and opioid addiction as short-term conditions: paper
Addiction to heroin and other opioids is a long-term, chronic disease that can't simply be fixed with a few weeks or months on methadone, a group of British Columbia-based researchers argue in a newly released paper. Designing treatment based on the belief that most addicts can become drug-free quickly -- or even at all -- is ineffective and dangerous, the report warns. The paper, published in the August edition of the journal Health Affairs, says research has repeatedly shown detoxification programs that use short-term bouts of methadone or similar therapies, reducing dosages over a period of weeks or months, are ineffective, with as many as 95 per cent of patients who complete such programs failing to stay clean. Read more here.

Alcohol Use, PTSD Improve with Naltrexone
The frequency of alcohol consumption decreased significantly more with naltrexone than with placebo in patients with comorbid alcohol dependence and post-traumatic stress disorder (PTSD), a randomized trial showed. The addition of opioid receptor antagonist to exposure therapy or supportive counseling resulted in the largest decreases in drinking days (about 65% to 70%), reported Edna B. Foa, PhD, of the University of Pennsylvania in Philadelphia, and colleagues. However, all patients treated with naltrexone had significantly fewer drinking days as compared with patients who received placebo plus one of the other interventions. Moreover, prolonged exposure therapy was not associated with drinking exacerbations, they wrote online in the Journal of the American Medical Association. Drinking days increased over time in all randomized groups, but patients treated with naltrexone and exposure therapy had the smallest increases, they added. Source: MedPage Today

Commentary: Drinking and the College Experience
Finally, in just a few short weeks, I’ll be heading off to college. My family and neighbors are eager to give me advice and well wishes. But I’m beginning to notice that those conversations have become pretty biased. “You’re going to what college? I heard the parties are great there!” or “You have Econ 101 on a Friday morning? I guess you’re going to be too hung over for that!”. Please click here to continue reading.

ER Visits Related to Stimulants Quadrupled Among Young Adults From 2005 to 2011
Emergency rooms reported a 300 percent jump in visits related to stimulant abuse among young adults from 2005 to 2011. According to The New York Times, 23,000 people ages 18 to 34 visited the ER in 2011 after taking drugs such as Adderall or Ritalin. The ER visits resulted from abuse or misuse of stimulants, including taking the drugs with alcohol, or taking larger-than-prescribed doses of pills. About one-third of the ER visits involved alcohol. Stimulants such as caffeine pills and caffeinated energy drinks were also included in the report. Illegal stimulants such as methamphetamine were not included. Caffeinated energy drinks were not a significant factor in the rise in stimulant-related ER visits. The findings come from the Substance Abuse and Mental Health Services Administration (SAMHSA), which found a particularly steep rise in ER visits for stimulant use among young adults ages 18 to 25. “Nonmedical use of any drug, even an over-the-counter drug, can be dangerous, but these [central nervous system] stimulants can potentially cause significant and lasting harm, including heart problems and addiction,” SAMHSA Chief Medical Officer Elinore F. McCance-Katz, MD, PhD, said in a news release. “We must raise awareness of this public health risk and do everything possible to prevent it.” According to SAMHSA, when these drugs are combined with alcohol, they can change a person’s perception of how intoxicated they are, and can increase the risk of alcohol poisoning or alcohol-related injuries.

Editorial: Recovery Court helps addicts and increases safety
Tennessee opened the nation’s first statewide Recovery Court last week at the Morgan County Correctional Complex. The facility will house up to 100 nonviolent offenders, freeing up traditional prison beds for more hardened criminals. The program promises to cut incarceration costs and recidivism rates by treating the substance abuse that so often is at the core of criminal activity. Continue here.

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